Evaluation of Hearing Impairment and Levels of Trace Elements in Patients with Oral Submucous Fibrosis

Introduction: Oral Submucous Fibrosis (OSMF) is a slowly progressive premalignant condition. Trace elements like Copper (Cu) and Zinc (Zn) were found to have diagnostic and prognostic values in malignancies. Disease activity at in an earlier stage by determining the exact stage of OSMF based on eustachian tube dysfunction and serum Cu, Zn, and Iron (Fe) levels.

Aim: To assess the Eustachian tube dysfunction and level of trace elements in OSMF patients.

Materials and Methods: This case-control study was carried out in VSPM Dental College and Research Centre Nagpur and Department of Ear, Nose and Throat (ENT) and Biochemistry of NKP Salve Medical College, Nagpur, Maharashtra, India, from March 2018 to February 2019. Two hundred patients were equally divided into individuals without OSMF and with OSMF. A Pure Tone Audiometry (PTA) was used to measure degree of hearing impairment while estimation of trace elements Cu, Zn and Fe was done by atomic absorption spectrophotometry. The unpaired t-test, Chi-square test and one-way Analysis of Variance (ANOVA) test were used for statistical analysis.

Results: All 200 individuals were matched with age and sex in both the groups. Normal hearing was found in 61% of the ears and Conductive Hearing Loss (CHL) in 39% of the ears with OSMF. A positive association of hearing loss in both the ears with stages of OSMF were seen which was statistically significant with p-value of 0.001. The level of Cu (103.44 mg/dL) was found increased in OSMF individuals while the levels of Zn (78.93 mg/dL) and Fe (84.05 mg/dL) was reduced.

Conclusion: Within the limitations of the study, there was association between the severity of OSMF, degree of hearing loss and levels of trace elements. One of the most serious side-effects of OSMF is hearing loss. Level of copper increased while level of zinc and iron were reduced in OSMF patients.